What could be more soothing than a relaxing soak in a warm, bubbling hot tub after a stressful day at work or a long day of strenuous physical activity? Warm water relaxing your muscles as it pulsates through spray jets all around your body can quickly make all things right with the world. Whether it's in an outdoor hot tub built for six or an indoor Jacuzzi tub for you alone, the hot tub experience has become a popular "splurge" item for more and more families. As with any water feature in a home where children are present, special care must be practiced to ensure the safety of little ones at all times.

According to the Consumer Product Safety Commission (CPSC), drowning is the main hazard associated with hot tubs and spas. Since 1990, the Consumer Product Safety Commission has recorded reports of more than 800 deaths in spas and hot tubs. About one-fifth of those deaths were drownings of children under the age of five. The CPSC states that spas and hot tubs should be covered with a locked safety cover when not in use and children should be kept away unless there is constant adult supervision.

Since 1990 the CPSC has reports of 43 incidents (including 12 deaths) in which people's hair was sucked into the suction fitting of a spa, hot tub, or whirlpool, causing the victim's head to be held under water. The CPSC states that hair entanglement occurs when a bather's hair becomes entangled in a drain cover as the water and hair are drawn through the drain. It adds that some of the incidents involved children playing a "hold your breath the longest" game which permitted long hair to be sucked into the drain. The CPSC was instrumental in helping develop a voluntary standard for drain covers that helps reduce the risk of hair entanglement. The CPSC advises consumers to make sure they have drain covers that meet this standard. If you are unsure, call a pool or spa professional and have them check the spa. Never allow a child to play in a way that could permit the child's hair to come near the drain. In fact, the Mayo Clinic goes as far as to advise that hot tub and spa users should never submerge their head in a hot tub or spa. If a drain cover is missing or damaged, shut down the hot tub or spa until the cover is replaced.

Hot tub temperatures are also a point of concern for both adults and children. The CPSC has documented several deaths as the result of extremely hot water (approximately 110°F). High temperatures can cause drowsiness, which can lead to unconsciousness, resulting in drowning. Additionally, increased body temperatures can lead to heat stroke and possible death. In 1987 the CPSC helped establish requirements temperature controls that help make sure hot tub and spa water temperatures never exceed 104°F.

According to the CPSC, there have also been 74 incidents since 1990 where various parts of the body have been entrapped by the strong suction of the drain. Once again, the CPSC was involved in the development of standards requiring dome-shaped drain outlets and tow outlets for each pump, which reduces the powerful suction if one drain becomes blocked.

Both the CPSC and Texas Children's Hospital advise that pregnant women and young children should consult with their doctors before using hot tubs. The Association of Pool & Spa Professionals (APSP) notes that infants and toddlers should not be permitted in a hot tub at all since a baby's thin skin makes them more susceptible to overheating. It also adds that no young child should be allowed in a hot tub until he or she can stand on the bottom and have his or her head remain completely out of the water. Regarding children, the APSP adds that children who are big enough should not use a hot tub for more than five minutes at a time, especially at the maximum temperature of 104°F. It also recommends that young children should avoid full body immersion and should instead use "jump seats," that permit only waist-high immersion.

The CPSC recommends following these safety precautions when using a hot tub, spa, or whirlpool:

Have a professional check your spa or hot tub and make certain it is in safe operating condition and that drain covers are in place and not cracked or missing. Check drain covers yourself periodically throughout the year.

Keep water temperatures at or below 104°F.

When the spa or hot tub is not in use, always use a locked safety cover.

Keep young children away from hot tubs and spas unless there is constant adult supervision.

Make certain the spa has the dual drains and drain covers conforming to and required by current safety standards.

Make certain all users (including children) know the location of the cut-off switch for the pump so that it can be turned off quickly in the event of an emergency.

Be aware that consuming alcohol while using a hot tub or spa could lead to drowning.

In addition, the International Code Council (ICC) states that, like a pool, hot tubs and spas should be surrounded by a fence at least four feet high with a self-latching gate or door in the fence (to make the area inaccessible to children and unauthorized people) or an approved, lockable safety cover.

And be sure to remember—your own home isn't the only place your child may encounter a hot tub or spa. Be aware of friends and family members your child may visit where a hot tub may also be present. Also remember that hot tubs may be present during stays at hotel, motels, or resorts while traveling or on your family vacation.

Hot tubs, spas, and whirlpools are wonderful additions to the home and a special treat that allows you to pamper yourself a bit after a long, stressful day. By educating yourself on the potential dangers, practicing regular maintenance, and providing vigilant adult supervision in the presence of children, you'll be able to enjoy a soothing, therapeutic soak in the hot tub with no additional worries!

Consult with your family physician or healthcare provider regarding any health concerns regarding your family, and consult with a hot tub or spa professional regarding safety and maintenance issues.

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